MICHAEL HECKER
Verona,PA
Summary
Healthcare operations and technology leader with 20 years of experience driving modernization, product strategy, and enterprise transformation. Deep expertise in Medicaid/Medicare programs, MITA frameworks, Lean Six Sigma, and Agile product development. Proven track record leading cross-functional teams, optimizing processes, and delivering data-driven solutions that improve organizational performance. Recognized for strong communication, stakeholder engagement, and the ability to guide complex initiatives from concept through execution.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Senior Business Analyst – MITA Consultant
Department of Healthcare Services (DHCS)
09.2023 - Current
- Lead Medicaid modernization initiatives as a Senior Business Analyst consultant for DHCS.
- Develop multi-year strategic recommendations aligned with CMS Final Rule and legislative changes to secure enhanced federal funding.
- Collaborate with HHS, CDPH, and other partners to transition legacy systems to modern MES-aligned solutions.
- Integrate MITA 3.0 and emerging 4.0 standards to improve program maturity, efficiency, and compliance.
- Conduct enhanced funding reviews, identify gaps, and deliver actionable recommendations to maintain CMS compliance.
- Evaluate APDs using the MITA APD Strategic Planning Framework to identify alignment and efficiency opportunities.
- Provide oversight and technical guidance for large-scale IT modernization projects.
- Review cost allocation plans to ensure alignment with CMS standards and program needs.
Senior Strategy Consultant – HealthPlaNET
UPMC Health Plan
Pittsburgh, PA
07.2019 - 09.2023
- Led product strategy across the full lifecycle, translating business needs into user stories and actionable requirements.
- Applied Lean methodologies to design innovative product solutions aligned with organizational goals.
- Analyzed large datasets using SQL and Excel, producing executive-ready insights and presentations.
- Built strong cross-departmental relationships to manage dependencies and ensure smooth product delivery.
- Developed structured roadmaps and launch plans using MVP and lateral-thinking approaches.
- Oversaw SaaS service requests and supported cloud-based data model development.
- Built and deployed low-code solutions using PowerApps, Power Automate, SharePoint, PowerBI, Visio, OutSystems, Jahia, and ShortPoint.
Supervisor of Intake
ZOLL Medical Corporation
Pittsburgh, PA
01.2013 - 07.2019
- Managed a 30-member team responsible for processing LifeVest requests across all payer types.
- Designed and implemented Excel macro automations that saved hours of daily work and reduced FTE costs.
- Conducted monthly quality audits and call reviews to improve customer experience.
- Developed and delivered training programs for new hires and new system implementations.
- Led training for 300 employees during rollout of a new eligibility system.
Senior Collections Account Representative
UPMC Corporate Services
Pittsburgh, PA
01.2012 - 01.2013
- Resolved patient grievances and provided transparent payment alternatives.
- Worked across multiple billing systems including Medipac and Epic.
- Managed insurance verification, billing, self-pay reports, and balance adjustments.
- Reviewed and determined eligibility for financial assistance applications.
Patient Services Business Representative
University of Pittsburgh Physicians (UPP)
Pittsburgh, PA
01.2008 - 01.2010
- Processed insurance claims across all payer types for UPP physician practices.
- Prioritized patient and insurance calls to resolve delayed claims.
- Utilized EPIC and payer portals to correct submission errors and resolve denials.
Education
Doctor of Business Administration (DBA) -
Franklin University
01-2029
Master of Business Administration (MBA) - undefined
Chatham University
Pittsburgh, PA01-2014
Bachelor of Science - undefined
Robert Morris University
Pittsburgh, PA01-2012
Skills
- Healthcare Operations & Strategy
- Medicaid Enterprise Systems (MES)
- MITA 30 / 40 Frameworks
- Agile Product Management (SAFe, AIPMM)
- KPI Development & Performance Optimization
- Enterprise IT Modernization (API, ML, AI)
- Cross-Functional Leadership
- Data Analysis (SQL, Excel, PowerBI)
- Low-Code Development (PowerApps, Automate, SharePoint, etc)
Certification
- Certified Lean Six Sigma Black Belt – SSGI Institute (2020)
- Certified SAFe Agilist Practitioner – Scaled Agile Inc. (2021)
- Certified Agile Product Manager & Product Owner – AIPMM / 280 Group (2023)
Timeline
Senior Business Analyst – MITA Consultant
Department of Healthcare Services (DHCS)
09.2023 - Current
Senior Strategy Consultant – HealthPlaNET
UPMC Health Plan
07.2019 - 09.2023
Supervisor of Intake
ZOLL Medical Corporation
01.2013 - 07.2019
Senior Collections Account Representative
UPMC Corporate Services
01.2012 - 01.2013
Patient Services Business Representative
University of Pittsburgh Physicians (UPP)
01.2008 - 01.2010
Master of Business Administration (MBA) - undefined
Chatham University
Bachelor of Science - undefined
Robert Morris University
Doctor of Business Administration (DBA) -
Franklin University